Abstract

Twenty-four patients between the ages of 8 and 48 years (median 27.5) with high-risk for relapse hematologic malignancy received a marrow transplant from an HLA and MLC compatible sibling donor after chemotherapy with busulfan, 4mg/kg/day for 4 days by mouth, cyclophosphamide 60mg/kg/day i.v. for 2 days, and etoposide 60 mg/kg i.v. over 4h on the first day of cyclophosphamide treatment (BU/CY/VP). Toxicity consisted of mucositis, skin rash, and nausea and vomiting in all patients, transient fever thought to be due to etoposide administration in 16/24 (67%) patients, and clinical veno-occlusive disease (VOD) of the liver in 4/24 (17%). There were nine deaths from causes other than recurrent disease in the first 100 days after transplant and two deaths after day 100, a total transplant mortality of 11/24 (46%). Three patients relapsed, but 10/24 (40%) remain alive and disease free 26-182 weeks (median 60 weeks) from transplant. These results compare favorably with results in a group of 12 similar risk patients treated with total body irradiation (TBI) containing regimens during an overlapping time period. Six of the TBI patients have had persistent or recurrent disease and only two (17%) are currently alive and disease free. The probability of disease persistence or relapse is 67% in the TBI group and 20% in the BU/CY/VP group (p<0.02).

Original languageEnglish (US)
Pages (from-to)489-495
Number of pages7
JournalBone marrow transplantation
Volume8
Issue number6
StatePublished - Dec 1 1991

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Busulfan
Homologous Transplantation
Etoposide
Hematologic Neoplasms
Immunosuppressive Agents
Bone Marrow Transplantation
Cyclophosphamide
Whole-Body Irradiation
Transplants
Therapeutics
Recurrence
Mucositis
Exanthema
Nausea
Vomiting
Mouth
Liver Diseases
Siblings
Cause of Death
Fever

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

@article{c783f6f8dc1f49658938debc86ae9089,
title = "Improved results of allogeneic bone marrow transplantation for advanced hematologic malignancy using busulfan, cyclophosphamide and etoposide as cytoreductive and immunosuppressive therapy",
abstract = "Twenty-four patients between the ages of 8 and 48 years (median 27.5) with high-risk for relapse hematologic malignancy received a marrow transplant from an HLA and MLC compatible sibling donor after chemotherapy with busulfan, 4mg/kg/day for 4 days by mouth, cyclophosphamide 60mg/kg/day i.v. for 2 days, and etoposide 60 mg/kg i.v. over 4h on the first day of cyclophosphamide treatment (BU/CY/VP). Toxicity consisted of mucositis, skin rash, and nausea and vomiting in all patients, transient fever thought to be due to etoposide administration in 16/24 (67{\%}) patients, and clinical veno-occlusive disease (VOD) of the liver in 4/24 (17{\%}). There were nine deaths from causes other than recurrent disease in the first 100 days after transplant and two deaths after day 100, a total transplant mortality of 11/24 (46{\%}). Three patients relapsed, but 10/24 (40{\%}) remain alive and disease free 26-182 weeks (median 60 weeks) from transplant. These results compare favorably with results in a group of 12 similar risk patients treated with total body irradiation (TBI) containing regimens during an overlapping time period. Six of the TBI patients have had persistent or recurrent disease and only two (17{\%}) are currently alive and disease free. The probability of disease persistence or relapse is 67{\%} in the TBI group and 20{\%} in the BU/CY/VP group (p<0.02).",
author = "Vaughan, {W. P.} and Dennison, {J. D.} and Reed, {E. C.} and L. Klassen and McGuire, {T. R.} and Sanger, {W. G.} and Kumar, {P. P.} and Warkentin, {P. I.} and Gordon, {B. G.} and Bierman, {P. J.} and Coccia, {P. F.} and Armitage, {J. O.}",
year = "1991",
month = "12",
day = "1",
language = "English (US)",
volume = "8",
pages = "489--495",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Improved results of allogeneic bone marrow transplantation for advanced hematologic malignancy using busulfan, cyclophosphamide and etoposide as cytoreductive and immunosuppressive therapy

AU - Vaughan, W. P.

AU - Dennison, J. D.

AU - Reed, E. C.

AU - Klassen, L.

AU - McGuire, T. R.

AU - Sanger, W. G.

AU - Kumar, P. P.

AU - Warkentin, P. I.

AU - Gordon, B. G.

AU - Bierman, P. J.

AU - Coccia, P. F.

AU - Armitage, J. O.

PY - 1991/12/1

Y1 - 1991/12/1

N2 - Twenty-four patients between the ages of 8 and 48 years (median 27.5) with high-risk for relapse hematologic malignancy received a marrow transplant from an HLA and MLC compatible sibling donor after chemotherapy with busulfan, 4mg/kg/day for 4 days by mouth, cyclophosphamide 60mg/kg/day i.v. for 2 days, and etoposide 60 mg/kg i.v. over 4h on the first day of cyclophosphamide treatment (BU/CY/VP). Toxicity consisted of mucositis, skin rash, and nausea and vomiting in all patients, transient fever thought to be due to etoposide administration in 16/24 (67%) patients, and clinical veno-occlusive disease (VOD) of the liver in 4/24 (17%). There were nine deaths from causes other than recurrent disease in the first 100 days after transplant and two deaths after day 100, a total transplant mortality of 11/24 (46%). Three patients relapsed, but 10/24 (40%) remain alive and disease free 26-182 weeks (median 60 weeks) from transplant. These results compare favorably with results in a group of 12 similar risk patients treated with total body irradiation (TBI) containing regimens during an overlapping time period. Six of the TBI patients have had persistent or recurrent disease and only two (17%) are currently alive and disease free. The probability of disease persistence or relapse is 67% in the TBI group and 20% in the BU/CY/VP group (p<0.02).

AB - Twenty-four patients between the ages of 8 and 48 years (median 27.5) with high-risk for relapse hematologic malignancy received a marrow transplant from an HLA and MLC compatible sibling donor after chemotherapy with busulfan, 4mg/kg/day for 4 days by mouth, cyclophosphamide 60mg/kg/day i.v. for 2 days, and etoposide 60 mg/kg i.v. over 4h on the first day of cyclophosphamide treatment (BU/CY/VP). Toxicity consisted of mucositis, skin rash, and nausea and vomiting in all patients, transient fever thought to be due to etoposide administration in 16/24 (67%) patients, and clinical veno-occlusive disease (VOD) of the liver in 4/24 (17%). There were nine deaths from causes other than recurrent disease in the first 100 days after transplant and two deaths after day 100, a total transplant mortality of 11/24 (46%). Three patients relapsed, but 10/24 (40%) remain alive and disease free 26-182 weeks (median 60 weeks) from transplant. These results compare favorably with results in a group of 12 similar risk patients treated with total body irradiation (TBI) containing regimens during an overlapping time period. Six of the TBI patients have had persistent or recurrent disease and only two (17%) are currently alive and disease free. The probability of disease persistence or relapse is 67% in the TBI group and 20% in the BU/CY/VP group (p<0.02).

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